Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias?
In patients with fibrotic idiopathic interstitial pneumonia (f-IIP), the diffusing capacity for carbon monoxide (DLCO) has been used to predict abnormal gas exchange in the lung. However, abnormal values for arterial blood gases during exercise are likely to be the most sensitive manifestations of l...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Pulmonary Medicine |
| Online Access: | http://dx.doi.org/10.1155/2012/657180 |
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| author | Benoit Wallaert Lidwine Wemeau-Stervinou Julia Salleron Isabelle Tillie-Leblond Thierry Perez |
| author_facet | Benoit Wallaert Lidwine Wemeau-Stervinou Julia Salleron Isabelle Tillie-Leblond Thierry Perez |
| author_sort | Benoit Wallaert |
| collection | DOAJ |
| description | In patients with fibrotic idiopathic interstitial pneumonia (f-IIP), the diffusing capacity for carbon monoxide (DLCO) has been used to predict abnormal gas exchange in the lung. However, abnormal values for arterial blood gases during exercise are likely to be the most sensitive manifestations of lung disease. The aim of this study was to compare DLCO, resting PaO2, P(A-a)O2 at cardiopulmonary exercise testing peak, and oxygen desaturation during a 6-min walk test (6MWT). Results were obtained in 121 patients with idiopathic pulmonary fibrosis (IPF, n=88) and fibrotic nonspecific interstitial pneumonias (NSIP, n=33). All but 3 patients (97.5%) had low DLCO values (<LLN) whereas only 66.6% had low KCO; 42 patients (65%) exhibited resting hypoxemia (<75 mmHg); 112 patients (92.5%) exhibited a high P[(A-a)O2], peak (>35 mmHg) and 100 (83%) demonstrated significant oxygen desaturation during 6MWT (>4%). Interestingly 27 patients had low DLCO and normal P(A-a)O2, peak and/or no desaturation during the 6MWT. The 3 patients with normal DLCO also had normal PaO2, normal P(A-a)O2, peak, and normal oxygen saturation during 6MWT. Our results demonstrate that in fibrotic IIP, DLCO better defines impairment of pulmonary gas exchange than resting PaO2, exercise P(A-a)O2, peak, or 6MWT SpO2. |
| format | Article |
| id | doaj-art-03629dfaaa9f4edab3a53c4d22bf0c3c |
| institution | Kabale University |
| issn | 2090-1836 2090-1844 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Medicine |
| spelling | doaj-art-03629dfaaa9f4edab3a53c4d22bf0c3c2025-02-03T06:07:20ZengWileyPulmonary Medicine2090-18362090-18442012-01-01201210.1155/2012/657180657180Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias?Benoit Wallaert0Lidwine Wemeau-Stervinou1Julia Salleron2Isabelle Tillie-Leblond3Thierry Perez4Clinique des Maladies Respiratoires, Centre de Compétence des Maladies Pulmonaires Rares, Hopital Calmette, Lille 2 University Boulevard Leclercq, CHRU, 59037 Lille, FranceClinique des Maladies Respiratoires, Centre de Compétence des Maladies Pulmonaires Rares, Hopital Calmette, Lille 2 University Boulevard Leclercq, CHRU, 59037 Lille, FranceUnité de Biostatistiques, CHRU, 59037 Lille, FranceClinique des Maladies Respiratoires, Centre de Compétence des Maladies Pulmonaires Rares, Hopital Calmette, Lille 2 University Boulevard Leclercq, CHRU, 59037 Lille, FranceClinique des Maladies Respiratoires, Centre de Compétence des Maladies Pulmonaires Rares, Hopital Calmette, Lille 2 University Boulevard Leclercq, CHRU, 59037 Lille, FranceIn patients with fibrotic idiopathic interstitial pneumonia (f-IIP), the diffusing capacity for carbon monoxide (DLCO) has been used to predict abnormal gas exchange in the lung. However, abnormal values for arterial blood gases during exercise are likely to be the most sensitive manifestations of lung disease. The aim of this study was to compare DLCO, resting PaO2, P(A-a)O2 at cardiopulmonary exercise testing peak, and oxygen desaturation during a 6-min walk test (6MWT). Results were obtained in 121 patients with idiopathic pulmonary fibrosis (IPF, n=88) and fibrotic nonspecific interstitial pneumonias (NSIP, n=33). All but 3 patients (97.5%) had low DLCO values (<LLN) whereas only 66.6% had low KCO; 42 patients (65%) exhibited resting hypoxemia (<75 mmHg); 112 patients (92.5%) exhibited a high P[(A-a)O2], peak (>35 mmHg) and 100 (83%) demonstrated significant oxygen desaturation during 6MWT (>4%). Interestingly 27 patients had low DLCO and normal P(A-a)O2, peak and/or no desaturation during the 6MWT. The 3 patients with normal DLCO also had normal PaO2, normal P(A-a)O2, peak, and normal oxygen saturation during 6MWT. Our results demonstrate that in fibrotic IIP, DLCO better defines impairment of pulmonary gas exchange than resting PaO2, exercise P(A-a)O2, peak, or 6MWT SpO2.http://dx.doi.org/10.1155/2012/657180 |
| spellingShingle | Benoit Wallaert Lidwine Wemeau-Stervinou Julia Salleron Isabelle Tillie-Leblond Thierry Perez Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias? Pulmonary Medicine |
| title | Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias? |
| title_full | Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias? |
| title_fullStr | Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias? |
| title_full_unstemmed | Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias? |
| title_short | Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias? |
| title_sort | do we need exercise tests to detect gas exchange impairment in fibrotic idiopathic interstitial pneumonias |
| url | http://dx.doi.org/10.1155/2012/657180 |
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